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DocuSign Envelope ID:05D7461F-6E02-485E-BC37-05A109DE2D2B <br /> ORANGE COUNTY-DEPARTMENT USE ONLY <br /> NOT A CONTRACT EXHIBIT OR ATTACHMENT <br /> Department <br /> PartyNendor Name: Tommy Lawrence Electrical PartyNendor Contact Person: Warren Taylor Contact Phone: 336 <br /> 599-4771 Party/Vendor Address: P.O. Box 641 City Roxboro State:NC Zip: 27573 Department: DEAPR Amount: <br /> $6,500 Purpose: Electrical service additions Budget Code(s): 61370035 880000 20039 Vendor#30928 (NIA if new <br /> vendor) Vendor is a BOCC consultant? Yes ❑ No® Contract Type: (Check one) New ® Renewal ❑ <br /> Amendment ❑ Effective Date 4/20/20154 Approved by Board Yes[]No® Agenda Date: <br /> This agreement is approved as to technical form and content: <br /> DocuSigned by: <br /> Department Director's Signature 50 aVt Sf0JA,0'L Date: <br /> 611CFA1D507A495... <br /> Information Technologies <br /> (Applicable only to hardwarelsoffware purchases or related ser4ces)This agreement has been reviewed and is <br /> approved as to information tecimology content and specifications: <br /> Office of the Director of Information Technology Date: <br /> Risk Management <br /> This agreement is approved for sufficiency of insurance standards,specifications,and requirements: <br /> DocuSigned by: <br /> Office of Risk Management Aura, 66Vtit 6 Date: <br /> 7FDCF9176800498... <br /> Financial Services <br /> This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control Act: <br /> DocuSigned byrr: <br /> Office of the Chief Financial Officer MAL l(fbVU Date: <br /> 232DFFC2CFA847B... <br /> Leval Services <br /> This agreement is approved as to legal form and sufficiency: <br /> DocuSigned by: <br /> Office of the County Attorney 161A,� 1°e�t i�S Date: <br /> EAAMKEMA8465... <br /> Cleric to the Board <br /> Received for record retention: <br /> Office of the Cleric to the Board Date: <br /> Revised 7/14 4 <br />